| NPI | 1215356225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LICHTE-MADAKASIRA Owner/President 601-664-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MS 0799) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2014-04-17 |